Leiomyosarcomas
Großes
Leiomyosarkom des Uterus bei einer Mittsiebzigerin. Computertomographie axial und sagittal.
Leiomyosarkom
des Uterus bei einer 75 jährigen Patientin in der Computertomographie links axial, rechts coronar. Der Uterus ist deutlich vergrößert (in einer Voruntersuchung wenige Monate zuvor noch klein atroph). Es zeigt sich eine unregelmäßige Kontrastierung suggestiv für Einblutung oder Nekrose.
Tumor and
tumorlike conditions of the pleura and juxtapleural region: review of imaging findings. Diagnosis: leiomyosarcoma. Technique: standard chest radiography and contrast-enhanced chest CT. Description: Postero-anterior and lateral chest radiographs (a, b) in a 64-year-old man show a well-delineated mass located posteriorly in the left lower lobe. Axial contrast-enhanced CT (c) reveals a smooth lobular mass with intralesional necrosis. There is no locoregional invasion of the adjacent structures. Imaging findings are relatively aspecific. On histopathologic examination, findings were consistent with a leiomyosarcoma
Uterine
leiomyosarcoma • Uterine leiomyosarcoma - Ganzer Fall bei Radiopaedia
Uterine
leiomyosarcoma • Uterine leiomyosarcoma - Ganzer Fall bei Radiopaedia
Leiomyosarcoma
• Leimyosarcoma of the small intestine - Ganzer Fall bei Radiopaedia
Pulmonary
metastases • Lung metastases from a leiomyosarcoma - Ganzer Fall bei Radiopaedia
Leiomyosarcoma
• Leiomyosarcoma of the uterus - Ganzer Fall bei Radiopaedia
Leiomyosarcomas are extremely rare malignant neoplasms that originate from smooth muscle cells and may be considered the malignant counterpart of a leiomyoma. They are classified as a soft tissue tumor and account for ~8% of malignant soft tissue tumors .
Pathology
Location
Leiomyosarcomas can potentially occur anywhere where there is smooth muscle. Commonly described sites include the following:
- uterus: uterine leiomyosarcoma: most common (account for up to one-third of uterine sarcomas )
- retroperitoneum: retroperitoneal leiomyosarcoma; most common non-uterine site
- stomach: gastric leiomyosarcoma
- esophagus : esophageal leiomyosarcoma
- small intestine: leiomyosarcoma of the small intestine
- liver: hepatic leiomyosarcoma
- bladder
- nasopharynx
- bone: primary leiomyosarcoma of bone
- venous structures
- central nervous system: primary intracranial leiomyosarcoma
Other sites include
- spermatic cord: spermatic cord leiomyosarcoma
- pulmonary artery: primary pulmonary artery leiomyosarcoma
Radiographic features
Morphological imaging features would be invariably dependent on the site (refer to individual articles). Generally, they tend to be large masses, especially with abdominopelvic lesions.
CT
- generally heterogeneous
- commonly demonstrate central low attenuation representing necrosis
- calcification exceedingly rare
MRI
The tumor frequently demonstrates cystic foci. Signal characteristics include
- T1: isointense to muscle
- T2 non-fat suppressed: intermediate to hypointense to neighboring fat
- T2 FS: predominantly hyperintense
Differential diagnosis
For a meaningful differential, it is necessary to consider site-specific tumors.
Siehe auch:
- retroperitoneales Leiomyosarkom
- gastrointestinal stromal tumors - leiomyoma/leiomyosarcoma
- tracheal leiomyosarcoma
- Leiomyosarkom des Magens
- leiomyosarcoma of the ileum
- Leiomyosarkom des Uterus
- Leiomyosarkom des Kolons
- Leiomyosarkome des Gastrointestinaltraktes
- Leiomyosarkom des Dünndarms
und weiter:
- hypervaskularisierte Leberläsionen
- Neurofibromatose Typ 1
- Liposarkom
- WHO-Klassifikation der Tumoren des zentralen Nervensystems
- WHO Klassifikation der Weichteiltumoren
- Tumoren der Thoraxwand
- Dünndarmtumoren
- Weichteilsarkom
- Lebertumoren
- embryonales Rhabdomyosarkom
- Budd-Chiari-Syndrom
- tumours of muscular origin
- muscular tumours
- hepatic leiomyosarcoma
- Leiomyosarkom der Vena cava inferior
- Leiomyosarkom des Ösophagus
- uterine leiomyosarcoma metastasis
- Leiomyosarkom der Vena cava
- Leiomyosarkom von Venen
- parasitisches Leiomyom
- Leiomyom des Uterus mit myxoider Degeneration
- entdifferenziertes Chondrosarkom
- paratestikuläre Tumoren
Assoziationen und Differentialdiagnosen zu Leiomyosarkom: